<div class="container">
    <div class="row clearfix">
        <div class="col-md-12 column">
            <div class="page-header">
                <h1>医院基本信息数据统计表</h1>
            </div>

            <form id="date-form" class="form-horizontal" Nice-validator>
                <div class="row align-items-end chose-row">
                    <div class="col-xs-12 col-sm-3">
                        <label class="control-label">{:__('请在历来所有季度中选择季度')}:</label>
                        <select id="quarter-select" name="quarter" class="form-control">
                            {volist name="quarterList" id="quarter"}
                            <option value="{$quarter.quarter}">{$quarter.quarter}</option>
                            {/volist}
                        </select>
                    </div>

                    <!-- 提交按钮 -->
                    <div class="col-xs-12 col-sm-3">
                        <button id="area-btn" type="" class="btn btn-primary">{:__('OK')}</button>
                    </div>

                    <!-- // 导出Excel -->
                    <div class="col-xs-12 col-sm-3 text-right">
                        <button id="export-btn" type="button" class="btn btn-success">{:__('导出Excel')}</button>
                    </div>
                    <!-- // 测试按钮 -->
                    <!-- <div class="col-xs-12 col-sm-3">
                        <button id="test-btn" type="" class="btn btn-primary">{:__('TEST')}</button>
                    </div> -->
                </div>
            </form>

            <div class="row clearfix table-content">
                <div class="col-md-12">
                    <div style="overflow-x: auto">
                        <table class="table table-bordered table-hover" id="hospitalCountTable">
                            <thead>
                                <tr class="text-center">
                                    <th class="text-left">项目\科室</th>
                                    <th class="text-center">ICU</th>
                                    <th class="text-center">外科</th>
                                    <th class="text-center">胸外</th>
                                    <th class="text-center">乳一</th>
                                    <th class="text-center">乳二</th>
                                    <th class="text-center">妇科</th>
                                    <th class="text-center">内一</th>
                                    <th class="text-center">内二</th>
                                    <th class="text-center">放一</th>
                                    <th class="text-center">放二</th>
                                    <th class="text-center">放三</th>
                                    <th class="text-center">结一</th>
                                    <th class="text-center">结二</th>
                                    <th class="text-center">结三</th>
                                    <th class="text-center">放射科</th>
                                    <th class="text-center">供应室</th>
                                    <th class="text-center">ECT</th>
                                    <th class="text-center">配液</th>
                                    <th class="text-center">窥镜</th>
                                    <th class="text-center">结门</th>
                                    <th class="text-center">门诊</th>
                                    <th class="text-center">手术室</th>
                                    <th class="text-center">功能科</th>
                                    <th class="text-center">护理部</th>
                                    <th class="text-center">总数</th>
                                </tr>
                            </thead>
                            <tbody class="text-center">

                                <!-- // 实际开放床位数 -->
                                <tr class="table-row input-first">
                                    <td class="text-left text-bold one-col">实际开放床数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">初全院执业护士总人数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <!-- // 末全院执业护士总人数 -->
                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">末全院执业护士总人数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <!-- // 初病区执业护士总人数 -->
                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">初病区执业护士总人数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <!-- // 末病区执业护士总人数 -->
                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">末病区执业护士总人数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <!-- // 岗执业护士上班小时数 -->
                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">岗执业护士上班小时数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <!-- // 导尿管拔管发生例次数 -->
                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">导尿管拔管发生例次数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <!-- // 胃肠管拔管发生例次数 -->
                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">胃肠管拔管发生例次数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <!-- // 中心导管拔管发生例次数 -->
                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">中心导管拔管发生例次数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <!-- // 气管导管拔管发生例次数 -->
                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">气管导管拔管发生例次数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <!-- // VAP发生例次数 -->
                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">VAP发生例次数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <!-- // CLABSI发生例次数 -->
                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">CLABSI发生例次数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <!-- // CAUTI发生例次数 -->
                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">CAUTI发生例次数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <!-- // 有创机械通气的总日数 -->
                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">有创机械通气的总日数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <!-- // 住院患者身体约束日数 -->
                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">住院患者身体约束日数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <!-- // II期及以上压疮发生例数 -->
                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">II期及以上压疮发生例数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <!-- // I期压疮发生例数 -->
                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">I期压疮发生例数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <!-- // 跌倒发生例次数 -->
                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">跌倒发生例次数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <!-- // 跌倒伤害严重度1级例次数 -->
                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">跌倒伤害严重度1级例次数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <!-- // 跌倒伤害严重度2级例次数 -->
                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">跌倒伤害严重度2级例次数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <!-- // 跌倒伤害严重度3级例次数 -->
                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">跌倒伤害严重度3级例次数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <!-- // 跌倒死亡例次数 -->
                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">跌倒死亡例次数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>

                                <!-- // 跌倒伤害总例次数 -->
                                <tr class="table-row">
                                    <td class="text-left text-bold one-col">跌倒伤害总例次数</td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                    <td class="">
                                        <input type="number" class="form-control" />
                                    </td>
                                </tr>
                            </tbody>
                        </table>
                    </div>
                </div>
            </div>
        </div>
    </div>
</div>

<style type="text/css">
    .container {
        width: 100%;
        background-color: #fff;
    }

    .chose-row {
        display: flex;
        align-items: end;
    }

    .table-content {
        margin-top: 20px;
    }

    .table-row>td {
        padding: 4px !important;
        vertical-align: middle !important;
    }

    .form-control {
        padding: 0 !important;
        text-align: center;
    }

    .one-col {
        width: 180px;
    }

    input[type="number"]::-webkit-outer-spin-button,
    input[type="number"]::-webkit-inner-spin-button {
        -webkit-appearance: none;
        margin: 0;
    }

    /* Firefox */
    input[type="number"] {
        -moz-appearance: textfield;
    }

    /* 隐藏不需要的月份 */
    .datetimepicker.quarter .month:nth-child(n + 5) {
        display: none;
    }
</style>